Metabolism of plasma triglycerides in hypothyroidism and hyperthyroidism in man.
Metabolism of plasma triglycerides in hypothyroidism and hyperthyroidism in man.
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发表时间：
1981-02
影响因子：
6.5
通讯作者：
J. Abrams;S. Grundy;H. Ginsberg
中科院分区：
文献类型：
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作者：
J. Abrams;S. Grundy;H. Ginsberg
对 10 名非肥胖和 16 名肥胖的甲状腺功能减退患者以及 13 名甲状腺功能亢进患者进行了血浆甘油三酯 (TG) 的研究。非肥胖、甲状腺功能减退患者的 TG 水平通常正常，但肥胖患者常常患有高甘油三酯血症。在大多数甲状腺功能减退患者中，1-甲状腺素治疗降低了血浆 TG，而大多数甲状腺功能亢进患者的 TG 较低。甲状腺激素降低血浆 TG 的一种机制可能是增加脂蛋白脂肪酶 (LPL)。然而，肝素治疗后 LPL 并没有升高，甲状腺功能亢进患者也没有升高。相反，甲状腺功能减退患者的肝素后肝甘油三酯脂肪酶水平异常低。在没有高甘油三酯血症的甲状腺功能减退患者中，乳糜微粒的清除率正常。一些患有空腹高甘油三酯血症的肥胖、甲状腺功能减退患者的乳糜微粒清除率较低，这可能部分是由于竞争去除多余的内源性甘油三酯。因此，没有获得甲状腺功能减退症患者乳糜微粒代谢显着异常的证据。非肥胖、甲状腺功能减退患者的极低密度脂蛋白 (VLDL)-TG 合成和清除正常。相比之下，8 名肥胖、甲状腺功能减退患者的 VLDL-TG 合成增加，且与肥胖、甲状腺功能正常的受试者相比，部分清除率相对较低。与此形成鲜明对比的是，甲状腺机能亢进患者在清除 VLDL-TG 方面具有显着的能力。因此，甲状腺功能减退症时，TG 代谢并未严重紊乱，但甲状腺激素显然可以促进 VLDL 的分解代谢。
Studies on plasma triglycerides (TG) were performed in 10 nonobese and 16 obese patients with hypothyroidism and in 13 with hyperthyroidism. Nonobese, hypothyroid patients generally had normal levels of TG, but obese patients often had hypertriglyceridemia. In most hypothyroid patients 1-thyroxine treatment lowered plasma TG, and most hyperthyroid patients had low TG. One mechanism whereby thyroid hormones might decrease plasma TG could be to increase lipoprotein lipase (LPL). However, post-heparin LPL was not increased after therapy, nor was it increased in hyperthyroid patients. In contrast, hypothyroid patients had abnormally low levels of post-heparin hepatic triglyceride lipase. In hypothyroid patients without hypertriglyceridemia, clearance of chylomicrons was normal. A few obese, hypothyroid patients with fasting hypertriglyceridemia had low clearance of chylomicrons, which may have been due in part to competition for removal of excess endogenous TG. Thus, no evidence was obtained for a significant abnormality in chylomicron metabolism in hypothyroidism. Nonobese, hypothyroid patients had normal synthesis and clearance of very low density lipoprotein (VLDL)-TG. In contrast, VLDL-TG synthesis was increased in 8 obese, hypothyroid patients, and fractional clearance rates were relatively low compared to obese, euthyroid subjects. In striking contrast, hyperthyroid patients had remarkable facility in clearing VLDL-TG. Thus, TG metabolism is not grossly deranged in hypothyroidism, but thyroid hormones apparently can promote catabolism of VLDL.